Payers require documented failure of topical steroids, methotrexate, and often phototherapy before approving biologics for psoriasis or atopic dermatitis. One missing line in the chart means a denial and a 2-week delay.
| Drug / Class | Common Denial Reason | PriorZap Prevention |
|---|---|---|
| Dupixent (dupilumab) | No documented topical steroid failure | Topical therapy history auto-captured from Rx record |
| Skyrizi (risankizumab) | PASI score not documented at baseline | PASI score capture triggered at order entry |
| Tremfya (guselkumab) | Missing phototherapy trial for moderate psoriasis | Phototherapy contraindication or trial auto-documented |
| Cosentyx (secukinumab) | Step therapy — must try MTX before biologic | MTX trial or contraindication auto-documented from FHIR |
| Ilumya (tildrakizumab) | Diagnosis code doesn't match biologic criteria | ICD-10 alignment validated against payer policy |
| Sotyktu (deucravacitinib) | TYK2 class — payer criteria not met | Real-time payer policy check at prescribing |
PriorZap captures step therapy documentation — topical steroid failure, phototherapy contraindications, PASI scores — automatically from your EHR at the point of prescribing, before a denial ever happens.